Properties (16)
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- Beyond the Auditory System
- (Meral Çetinkaya et al., 2026)
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Beyond the Auditory System: Sensory Processing in Decreased Sound Tolerance Disorders
Status:: #status/Bare-bones-review
Metadata
- Item Type: #journalArticle
- Authors:: Merve Meral Çetinkaya, Azize Arzu Koçyiğit Köroğlu, Ümit Can Çetinkaya,
- Date Added: February 14, 2026
- URL: https://brill.com/view/journals/msr/aop/article-10.1163-22134808-bja10185/article-10.1163-22134808-bja10185.xml
- DOI: 10.1163/22134808-bja10185
- Cite Key: meralcetinkayaAuditorySystemSensory2026
- Tags:: #Misophonia, #sensory-processing, #decreased-sound-tolerance-(DST), #sound-tolerance-disorders,
- PDF Attachments
Abstract
| Background/Purpose | Background- • DST includes hyperacusis, misophonia, and phonophobia. • DST forms may co-occur. • Research has focused on auditory processing in DST. • Limited research examines non-auditory sensory systems in DST. • No prior study examined DST and sensory processing sensitivities in normally hearing adults without neurological disease. Purpose- • To investigate the correlation between DST and SPD. • To identify which sensory systems are affected when DST exists. |
| Participants/samples | • N = 315 adults (18–35 years). • Normal hearing (≤20 dB HL); no neurological disorders. • DST group: n = 278 (≥1 DST type). • Control (non-DST): n = 37. • Excluded: hearing loss, neurological disease, ear surgery/infection. |
| Measures | • DSTS-S (hyperacusis, phonophobia, misophonia subscales; cut-offs applied). • ASPS (11 sensory factors; total score; categorical classification). • Demographic questionnaire (age, gender, income, tinnitus, psychotropic medication). |
| Procedures | • Pure-tone audiometry (125 Hz–8 kHz). • Self-report completion of DSTS-S and ASPS. • Partial correlations controlling for other DST types. • Independent t-tests. • Binary logistic regression using ASPS total score predicting DST categories. |
| Results | Prevalence/Distribution • Triple DST most common; dual and pure forms also present. • Small non-DST control group. Hyperacusis • Positively associated with ASPS total. • Positively associated with auditory overresponsiveness. • Positively associated with visual, social touch, texture-related touch overresponsiveness. • Positively associated with overall underresponsiveness and proprioceptive–vestibular underresponsiveness. • Negatively associated with auditory seeking. • No significant group differences vs non-DST; logistic regression non-significant. Phonophobia • Positively associated with vestibular over responsiveness. • Negatively associated with auditory seeking. • No other significant associations. • No significant group differences or regression findings. Misophonia • Positively associated with ASPS total. • Positively associated with auditory over responsiveness and auditory seeking. • Positively associated with visual, social touch, texture-related touch over responsiveness. • Positively associated with proprioceptive seeking, tactile under responsiveness, movement intolerance, proprioceptive–vestibular under responsiveness. • Pure misophonia higher than non-DST on selected ASPS domains and total. • ASPS total predicted pure misophonia. Dual and Triple DST • Higher ASPS total than non-DST. • Higher vestibular, auditory, visual, social touch over responsiveness. • Higher movement intolerance and texture-related touch over responsiveness. • Higher overall under responsiveness and proprioceptive–vestibular under responsiveness. • Tactile under responsiveness elevated in triple DST. • ASPS total predicted dual and triple DST. Demographics, tinnitus, medication, income, education: not significantly different between DST and non-DST. |
| Discussion/Limits | Conclusion- • The authors conclude that DST may involve sensitivity beyond the auditory system. • The findings indicate that hyperacusis includes broader sensory reactivity profiles. • The data support that misophonia presents a multidimensional sensory profile affecting multiple sensory domains. • The authors conclude that co-occurring DST types reflect complex sensory modulation patterns. • The findings indicate that sensory processing may be affected in the presence of single or multiple DST types. • The authors conclude that individuals with normal hearing and no neurological disorders with DST may have difficulty processing visual, vestibular, proprioceptive, and tactile stimuli. |
| Limitations:: | • Only self-report scales used. • No objective sensory or sound discomfort measures. • Screening tools not diagnostic. • Small subgroup sizes (pure hyperacusis, pure phonophobia). • Overlap among DST types limits clarity and generalizability. |
| Future Directions:: | • Include objective and physiological sensory measures. • Larger and more balanced subgroup samples. • Assess quality of life, depression, and anxiety. • Collaborate with occupational therapists for targeted interventions. • Examine rehabilitation programs targeting proprioceptive integration. • Investigate balance and postural control mechanisms in hyperacusis. |
| Statistics:: | Sample: N=315; DST=278; non-DST=37. Triple=35.9%; Dual=27.0%; Hyperacusis only=5.1%; Phonophobia only=4.4%; Misophonia only=15.9%; None=11.7%. Correlations (ASPS total): Hyperacusis r=0.260, p<0.001; Phonophobia r=0.071, p=0.212 (NS); Misophonia r=0.348, p<0.001. Hyperacusis: Auditory OR r=0.400, p<0.001; Visual OR r=0.119, p=0.035; Social touch OR r=0.291, p<0.001; Overall underresponsiveness r=0.134, p=0.018; Proprioceptive–vestibular underresponsiveness r=0.158, p=0.005; Texture touch OR r=0.184, p=0.001; Auditory seeking r=−0.150, p=0.008; NS others. Phonophobia: Vestibular OR r=0.133, p=0.019; Auditory seeking r=−0.145, p=0.010; Texture touch OR r=−0.126, p=0.026; NS others. • Misophonia: Auditory OR r=0.341, p<0.001; Visual OR r=0.178, p=0.002; Social touch OR r=0.124, p=0.029; Proprioceptive seeking r=0.140, p=0.013; Proprioceptive–vestibular under responsiveness r=0.205, p<0.001; Auditory seeking r=0.248, p<0.001; Tactile under responsiveness r=0.172, p=0.002; Movement intolerance r=0.265, p<0.001; Texture touch OR r=0.198, p<0.001; NS others. • Logistic regression (ASPS total): • Pure hyperacusis OR=1.011, p=0.488, R²=0.013 (NS). • Pure phonophobia OR=0.997, p=0.845, R²=0.001 (NS). • Pure misophonia OR=1.038, p=0.009, R²=0.116. • Dual DST OR=1.086, p<0.001, R²=0.406. • Triple DST OR=1.090, p<0.001, R²=0.518. Group comparisons: Dual and triple DST > non-DST across multiple ASPS domains (p<0.05); pure hyperacusis and pure phonophobia NS; pure misophonia elevated in auditory overresponsiveness, proprioceptive–vestibular underresponsiveness, and total. |
| Relevance:: | • study looked at correlation between decreased sound tolerance disorders ( including Misophonia) and sensory processing disorder, finding that decreased sound tolerance was associated with processing issues in other modalities including visual, vestibular, proprioceptive, and tactile. • a good sources for info on co occurrences of different sensory processing issues as well as Misophonia |
Notes
key terms and concepts:
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Decreased Sound Tolerance (DST) – adverse reactions to sounds that would not typically elicit a negative response in the average individual.
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Hyperacusis – excessively loud perception of sounds available in daily life, caused by abnormally high activation of the auditory system.
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Misophonia – excessive emotional responses to certain sounds.
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Phonophobia – fear experienced in response to certain sounds, believed to be caused by abnormal activation of the limbic and autonomic nervous systems.
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Sensory Processing Disorder (SPD) – difficulties in regulating sensory sensitivity or habituation across sensory domains.
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Adult Sensory Processing Scale (ASPS) – 48-item scale assessing over responsiveness, under responsiveness, and seeking behaviors across sensory domains.
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Decreased Sound Tolerance Scale–Screening (DSTS-S) – 33-item screening tool assessing hyperacusis, misophonia, and phonophobia.
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Bookmarks
- bookmark for talking about Misophonia results (page 14)